Women are the unpaid case workers of the American health care system and they don’t trust insurers mainly because insurers aren’t doing enough to earn that trust. Among other things, price transparency and better cooperation between payers and providers might help address this situation.
By some accounts, pregnancy and delivery is the single most expensive group of diagnoses for employers providing insurance coverage. Contraception coverage is in the ACA and it’s a good deal for insurers because contraception prevents unintended pregnancies. But complaints about limited options abound.
Long-lasting reversible contraceptives (LARCs) are easy to use and effective. One reason the U.S. lags behind other developed countries in LARC use is that memories of the Dalkon Shield still linger from the 1970s, when a design defect in that IUD resulted in infections that led to infertility, ectopic pregnancies, and death.
Guideline writers are dialing back breast screening recommendations because of concerns about false positives and overdiagnosis. But advocates and some clinicians are pulling in the opposite direction—for more coverage, especially for 3D mammography.
Doctors maintain that they simply do not have all the tools they need to make value-based care happen, even if they wanted it to happen. Health insurance executives counter that the situation is not that bad.